Leisure, Recreation, and Life Satisfaction: A Longitudinal Study for People With Spinal Cord Injury.

Background: Leisure and recreation (LR) are positively associated with social integration and life satisfaction in people with spinal cord injury (SCI). However, few studies have longitudinally observed long-term changes in LR participation among people with SCI and discussed the association of these activities with social integration and life satisfaction. Objectives: This study aims to determine for people with SCI, within a 45-year period, the association between mobility and LR participation; the associations between LR participation and social integration and life satisfaction, respectively; and whether the association between LR participation and life satisfaction is mediated by social integration. Methods: Growth modeling and linear mixed modeling were employed as the primary data analysis tools to explore longitudinal changes in LR participation, social integration, and life satisfaction. A mediation test was conducted to examine the potential mediation effect of social integration on the relationship between LR participation and life satisfaction. Results: The mobility level, LR participation hours, and social integration of people with SCI decreased gradually during the 45-year period, whereas life satisfaction increased as they lived longer with the injury. LR participation was consistently and positively associated with social integration and life satisfaction of people with SCI. A mediation effect by social integration was observed between LR and life satisfaction. Conclusion: A decline in mobility level was associated with a decrease in LR participation over time for people with SCI. Engaging in LR activities regularly and maintaining a certain level of social interaction are consistently and positively associated with long-term life satisfaction.

How environmental and psychological factors interact with travel participation after spinal cord injury.

PURPOSE/OBJECTIVE: Spinal cord injury (SCI) usually causes neurological impairment, which can make traveling to places challenging. The ability to travel is nevertheless essential for societal participation, and full participation of persons in society after SCI is a key indicator of successful rehabilitation. Research has widely documented lowered level of participation of people living with SCI. To offer insights for effective intervention, the study aims to examine how psychological and environmental factors influence participation in travel related activities after SCI. Based on the self-determination theory (SDT) and the literature in participation research, the study proposed a model depicting the interrelationships among travel barriers, travel need satisfaction, travel motivation and participation of people with SCI in travel-related activities. RESEARCH METHOD/DESIGN: Cross-sectional quantitative data were collected from 250 individuals enrolled in a SCI model system. RESULTS: Path analysis reveals significant negative effect of travel barriers on respondents' need satisfaction for autonomy, which in turn affects controlled motivation (introjected and external) and amotivation. Only external motivation leads to participation in travel while amotivation negatively influences travel participation. Travel barriers were found to indirectly influence travel participation through need satisfaction for autonomy, external motivation and amotivation. CONCLUSIONS/IMPLICATIONS: Although people have high intrinsic motivation for travel, they do not travel for fun as much as for external motivations after SCI. Travel barriers can lower people's need satisfaction for autonomy, which results more travel for external motivation. The study provides preliminary evidence supporting an SDT-based travel participation model after SCI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multi-stakeholder perspectives of environmental barriers to participation in travel-related activities after spinal cord injury.

PURPOSE: To help enhance participation, the study aims to identify and document a comprehensive list of environmental barriers for people with SCI in the broad travel setting. METHODS: Semi-structured interviews were conducted among four stakeholder groups: people with SCI (n= 39), caregivers and family members of people with SCI (n= 24), therapists who work with people with SCI (n= 9), and travel professionals specializing in accessible travel (n= 11). RESULTS: Five major categories of travel barrier emerged from the interviews: Partial Accessibility, Systemic Ignorance, Travel Hassles, Poor Service Performance, and Lack of Support. Detailed barriers in each category are described. The analysis of multi-stakeholder perspectives indicates while respondents with SCI offered the most specific information about the barriers, family members/caregivers were most concerned about the impact of systemic ignorance on their loved ones. Therapists focused on offering their clients tools to overcome barriers, and travel agents emphasized their limitations of serving customers with disabilities. CONCLUSION: Results of the study should help not only health and travel professionals better assist individuals to reintegrate into society after SCI, but also travel and hospitality businesses to better meet the accessibility needs of people with SCI.Implications for rehabilitationTravel is important to full participation in society for people after SCI.The study has identified five categories of barriers to travel participation after SCI: partial accessibility, systemic ignorance, travel hassles, poor service performance and lack of support.While traveling is important for participation in society for people with SCI, rehabilitation professionals should work together with policy makers, travel and hospitality businesses and agencies to lower the found barriers.

Contribution of travel participation to social integration and life satisfaction after spinal cord injury.

BACKGROUND: Research has found that participation in travel declines for people after spinal cord injury (SCI) because the traumatic injury usually results in impaired physical mobility and sensation, and barriers in the environment make travel more challenging. While travel participation can offer numerous physical, psychological, and emotional benefits, empirical evidence on positive outcomes of travel for people after SCI is scarce in the literature. OBJECTIVE: To empirically examine the effects of travel participation on social integration and life satisfaction for people with SCI, along with other personal characteristics including income, self-perceived health status, levels of physical independence, occupational activities, and travel barriers. METHODS: Cross sectional data are collected from 250 patients enrolled in a SCI Model System. Hierarchical regression analyses, followed by mediation analyses, are conducted to assess the effects of travel participation on social integration and life satisfaction. RESULTS: Travel participation along with occupational activities is shown to significantly impact social integration, with participation in occupational activities partially mediating the relation from travel participation to social integration. The significant effect of travel participation on life satisfaction is fully mediated by social integration. Income and self-perceived health status both significantly contribute to social integration and life satisfaction. CONCLUSIONS: Travel participation should be considered as an independent domain that directly impacts the social integration of people with SCI, which in turn enhances their life satisfaction. Systematic interventions with standard protocols for travel-related skill training and assessments procedures are needed for people after SCI.